The Impact of Chronic Medical Conditions on Adolescents - Term Paper Example

The Impact of Chronic Medical Conditions on Adolescents Student’s Name University The Impact of Chronic Medical Conditions on Adolescents Introduction Prevalence and incidences of chronic diseases have been on the rise in different nations and WHO (2007) posits that they will be the main cause of death by 2020 (Michaud, Suris & Viner, 2007). Adolescents between the ages of 12 and 18 are experiencing major health problems despite an increase in life expectancy. Constant improvements taking place in hygiene, control of infectious diseases and nutrition have resulted in a shift in epidemiology such that disability and non-communicable diseases have emerged as major health issues. A study done by the Centers for Disease Control and prevention (CDC, 2009) revealed that, this transition in the manifestation of health problems is already taking place in developed countries. The effects that chronic medical conditions have on adolescents are multifaceted. The developmental processes that adolescents go through are categorized into three, including early adolescence, middle and late adolescence. Every stage has particular physiological, biological, social and psychological phases. The nexus between chronic diseases and adolescents is twofold. While chronic conditions have the potential to significantly impact the developmental processes, the changes adolescents go through in their development also have the potential to affect the nature of chronic conditions. Psychological and physiological adjustments to an adolescent’s body can influence the nature of a chronic condition. Thus, the effects of adolescent maturation and chronic conditions are reciprocal. Body Effects of chronic illnesses on adolescents Impact on puberty and growth Chronic conditions have an impact on puberty and growth. Chronic illnesses cause disruption of various biological processes in the body through various processes triggered by different conditions. These processes cause delays in puberty, growth and maturation Gastrointestinal disorders, such as cystic fibrosis, cause malabsorption, while chronic infections and inflammations result in a competition for nutrients. There is also an increase in nutritional requirement owing to more physiological work, such as in individuals with asthma. In cases where the patient is experiencing hypoglycemia in diabetes or liver or liver failure, there is an accumulation of toxins, and this excess interferes with growth factor in adolescents (Cockram, 2000). Hypothalamic hormones, such as the growth hormone and gonadotrophins are also down-regulated by chronic illnesses owing to unavailability of nutrients, damage to the hypothalamus (like in thalassemia), low weight, cytokine production like in chronic arthritis and stress, which also reduces the production of hormones (Michaud, Suris & Viner, 2007). Stress is also triggered by medications that these adolescents take for their condition, such as steroids. It is common to witness a growth delay in adolescents with chronic illnesses. However, it is more common in those with conditions that are characterized with chronic inflammation and malnutrition, such as cystic fibrosis and bowel disorders. It is important to note that, the delay in growth is often transient with the adolescent having catch-up growth resulting in normal height when they reach adulthood. There is a possibility of permanent growth loss, as well. Research has found that, an adolescent suffering from physical chronic illnesses is likely to catch up in growth, while those suffering from psychological chronic illnesses, such as enuresis and other mental problems, will likely show signs of growth delay even in adulthood, such as being short (Eiser & Morse, 2001). These conclusions were made after the controlling of other growth influencers, such as socioeconomic status and genetic factors. Impact on psychological development Chronic illnesses also affect the psychological development of individuals. The wellbeing of adolescents with chronic illnesses is dependent on the severity of the condition, as well as the treatment the individual is undergoing. This is because; the severity and the treatment are characterized by different social and psychological complications. The variations in the psychological complications that accompany chronic conditions is evident in the different, and sometimes contradictory, results that are the products of different studies. Adolescents with chronic illnesses are likely to internalize problems compared to their healthy counterparts. In addition, girls are more susceptible to chronic illnesses than boys are. Chronically ill female adolescents are likely to have long-term issues than boys. Their problems may also be more serious than they are for boys (Power & Eliot, 2006). Other results have found that, there are psychological issues that chronically ill females may have chronic illness unlike boys. Chronically ill adolescents are likely to have at least one psychiatric diagnosis. They are also more susceptible to low self-esteem and diabetes. Another factor that influences the development of psychological problems is that, the adolescents are at a time when social interaction and belonging to a group are most essential to their development. Thus, chronic illnesses may sideline them from their colleagues. Developmental issues that accompany chronic illnesses also make them susceptible to self-esteem issues. According to Groesz et al (2002), self-image is a major determinant of emotional wellbeing in adolescents. Hesse-Biber et al (2006) also posited that the focus on thinner bodies as the ideal image to be upheld by adolescents’ results in the development of eating disorders, which are also categorized as chronic conditions. Adolescents with conditions, such as asthma, often experience high levels of depression and loneliness. Impact on cognitive abilities The effect of chronic illnesses on the cognitive abilities of adolescents is rare. However, the neuronal maturation of an individual may be affected by the process of the diseases, such as cerebrovascular accidents in those with sickle cell disease, and hypoglycemia in diabetes. When these neuropsychological effects occur in adolescents, they result in a disruption of the development of cognitive abilities, such as abstract thinking (Serjeant, Singhal & Hambleton, 2001). On the other hand, there are effects that stem from generic effects of chronic illnesses rather than the process. Research shows that, ego development, self-image and identity are influenced by the generic factors of chronic illnesses (Cepeda et al, 2000). This is common in situations where the illness is severe while the verbal abilities of the patient remain high. Development and body image are impaired, such as the development of a sense of the sexual, and sometimes, there are conditions that result in distortions of the physical characteristics of an individual, such as scars and stomas. Dissatisfaction and issues with the body significantly impair the sexual functions of the adolescent later in life. However, it is also important to note that, the same issues affect the sexual behaviors since they tend to display higher levels of risky sexual behavior. Impact of development on management of chronic illnesses Developmental changes that occur in adolescents including modifications of their social, psychological and physical capacities affect the management and course of chronic illnesses. In this capacity, they affect treatment and supervision strategies, strategies plausible to healthcare professionals and self-management strategies, and options (Epping-Jordan et al, 2001). However, most of these effects are similar to those of other conditions. For instance, school nurses often have inhalers as preparation for dealing with asthma attacks. Behaviors the promote health and wellbeing Health promotion initiatives that are implemented around the world are based on the premise that, having knowledge on causes of illnesses and the alternatives available to them is instrumental in preventing illnesses. Health-compromising behaviors are sometimes initiated at when individuals are adolescents, such as unprotected intercourse, unhealthy eating, smoking and binge drinking. Most health promotion programs hope that an individual will act on what is best for them based on the premise that, they want to survive. The evolution theory shows that, the development of an individual’s brain is extraordinarily protracted (Keverne, 2004). Unlike the other organs in an individual’s body, the development of the brain mostly occurs post-natally. Since the brain is designed to respond to contextual specifications of development. Dawson et al (2000) posit that, the major phases of development happen before an individual reaches two years of age. However, major reorganization and development continue up to puberty. Frontal lobe developments continue to adulthood. In mammalian species, the social environment affects the development of the brain. This is why most health promotion initiatives are based on using the social environment to change the behavior of an individual. The attachment theory emphasizes the importance of the bond between mother and child. Infants with secure attachment are more open to exploring and accepting the changes in their environment (Ainsworth & Bell, 1970). They also respond to strangers more positively than those who had insecure attachment. Changing the environment is a major step in changing the behavior of adolescents. Behaviors, such as smoking, drinking and reckless sexual behavior, are likely to be deterred in individuals who had secure attachment, because; they will be more receptive to the changes in their environment. Fredrickson’s broaden and build theory supports this as it states that the presence of positive emotions in a child’s development affect the cognitive processes of the child, making them resilient in later stages such as puberty (Fredrickson, 2004). Resilience is important in ensuring that individuals adopt behaviors that are proposed for changes that will result in health and well-being. It is essential in helping adolescents make the right decision even if the decision costs them other things, such as social status as school. Fredrickson (2001) also points out that, there is a greater chance that one’s emotional coping mechanisms will be expanded if they are positive thinkers. Negative emotions narrow the repertoire of thought, while positive thought broaden thought repertoire. WHO proposes that, the changes that promote well being should include having a friendly environment at school, reframing the health system, and using youth friendly services. These initiatives can only succeed if the outlook of the adolescent is changed from the inside. Conclusion Chronic illnesses have an impact of adolescents in terms of developmental, psychological, and cognitive domains. In addition, the development an adolescent goes through also affect the nature of the chronic illnesses especially in terms of management. Behavioral, cognitive and emotional changes that are likely to result in the enhancement of health and wellbeing hinge on the presence of certain conditions, including a positive outlook from the adolescent. The evolution, broaden and build and attachment theories explain why the effectiveness of these practices hinge on the adolescent’s childhood experiences in development. In addition, biological factors, such as hormonal changes in puberty, also influence the path one is likely to take in making changes. References Ainsworth, M. D., & Bell, S. M. (1970). Attachment, exploration, and separation: Illustrated by the behaviour of one-year-olds in a strange situation. Child Development, 41, 49-67 Centers for Disease control and Prevention (CDC). (2009). The power of prevention: Chronic disease…the public health challenge of the 21st century. Retrieved from http://www.cdc.gov/chronicdisease/pdf/2009-power-of-prevention.pdf Cepeda, M., et al. (2000). Physical growth, sexual maturation, body image and sickle cell disease. Journal of the National Medical Association, 92(1), 10–14. Cockram, C. (2000). The epidemiology of diabetes mellitus in the Asia-Pacific region. 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